KNEE ARTHRITIS - Changing the forces through the joint :

HTO & ACI - - Posted by Lizzie (Lizzie - UK), 15 January 2005

Just wondered how many on here have had both a HTO as well as ACI.

I have been told that I need an HTO immediately, but also the likelihood of having to have an ACI is imminent, dependant on the MRI.

I want to know how long the Stage II surgery was, including the HTO.

I want to know if the HTO was fixed with internal or external fixation, or simply with a cast.

I also want to know how long you had to stay in hospital.

How long before you were in a CPM

Whether you had to keep your leg straight

I have so many questions that I would like to know the answers, before I see the OS again.  

Unfortunately my private insurance does not cover MRIs and I will have to wait 22 weeks for the MRI, unless I am lucky and get a cancellation.  The probability of this might be quite high, as a lot of the patients that come to this hospital have fair distances to get there.  For example, I spoke to one lady who had travelled 260 mile round journey.  

Anyone that can help with at least some of the answers to my questions, I would be greatly appreciative.

I want to make sure that I am as clued as I can be.

Cheers
Lizzie
Posted by craiggers (craiggers), 19 January 2005

( This is a repost of my reply/advice to another member )

Hey ....

This is my first time to this site but I am 11 days Post-Op of a High Tibial Osteotomy.  I was given the Opening Wedge to correct slight bowlegged deforimity on my left leg.  Previously, I have 2 ACL reconstructions.  One using my Hamstring, very painful.  That one gave out on it's own.  The second was 2 years later and I used an Allograft.  That one held in place but due to my slight deformity I as threatining to have my cartilidge rubbing together.  It was a big decision to have this done.  There is an Allograft Wedge, with a graft from my Hip to help the graft take.  It is QUITE painful.  Not so much at the site of the tibia, but the Hip is a killer.  I have a EBI X Fix plate in there to bring it all together.  In the hospital I had a JP drain installed to prevent pooling of blood and infection.  Plan to stay in the hospital for 3-5 days.  They will not let you leave if you are losing too much blood( above 10ml per 8 hours), you must be able to get to the bathroom and maybe shower, and you must be able to walk on crutches.  The pain is tolerable, and cramping may occour...That hurts.  Make sure you get a Cryo-Cuff for the area and get the Ice exchanged regularly...That will be your best friend.  I had a Immobilizer Brace on my leg while in the hospital.  By the third or fourth day the drain will be removed and you wil be on your way.  The cuff will no longer be necessary if you are not swelling.  In fact, I started using heat for cramps.  All in all, if you want to have problem free knees, have the opeation.  A Total Knee is also an option.  I CAN'T STRESS ENOUGH TO  GET A DOCTOR WHO KNOWS WHAT THEY ARE DOING HERE !!!  A Osteotomy with a External Fixator is more precise, but takes longer...Both ways have their pros and cons, you have to decide which one is right for you.
You WILL get BORED !!!   Probably out of your mind...I know I am...I have a Bledsoe Brace on and mosty I have it in extended position.  You will be able to bend your leg, but, keep it extended and fixed for a while.  That is the hardest thing to get back.  Do excercises daily, get strength, and get movement back.  I hope this helps a bit.  It is tough going for a while, but you have to look towards the future.  Ask yourself if it is worth it to you, get opinions, get the best doctor you can...Don't be afraid to ask ANYTHING !!!  It is YOUR leg, you deserve to know all you can...So, I am still healing, feeling better everyday, no pain killers necessary...I am glad I did it.
Oh yes, get used to sleeping ONLY on your back !!!  
I have found over the years that pain Killers are NOT your best friend...Use the ONLY when necessary, Ok  
Tylenol 500mg do the trick wisely when you get home.  If you can't sleep, get a script for some Ambien...  You need to know when you have pain in this type of operation.  The risks are low, but you have to be sure...

I have never been on a CPM machine, I don't see the need....

Let me know if you need any more advice, Ok  

Craig  



Posted by Lizzie (Lizzie - UK), 19 January 2005

Hi Craig

Thanks for the quick reply.  You have gone into a lot of detail and I really appreciate that.  Thanks.

Unfortunately the subject of painkillers is a difficult one and I have chronic pain and fatigue syndrome and am on an alternative drug that is equivalent to 280mg over a 72 hour period.

I've got a cryocuff somewhere in one of my cupboards so I will have to remember to get it out and make sure that it works.

The surgeon that I am seeing is one of the best in the UK for doing ACI's.  In fact he worked with Professor Bently who helped, I believe, pioneer the work at the hospital that I am attending.  And the Royal National Orthopaedic hospital is the BEST hospital in the UK and is solely for orthopaedic related illnesses.


With regard to the boredom, I've been on longterm sickness since December 2001 - I've got my DVD's and my Ipaq 4705 that I can watch DVD's as well as listen to MP3's.  I think I've got this one covered!!  

I wish you well with your recovery and thanks again for your very helpful reply.

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